Method and apparatus for performing a less invasive shoulder procedure
View Patent ↗A method and apparatus of performing a procedure relative to the glenohumeral joint. Resection of the glenoid and/or the humerus can proceed through an incision formed near the glenohumeral joint. The incision can be formed generally near a superior-lateral portion near the glenohumeral joint and allow less invasive access to the glenohumeral joint and the portions that form the glenohumeral joint. A stem is positioned into a resected humerus through the incision. A humeral head is coupled to the stem within the incision after the stem has been coupled to the patient's humerus.
1. A method of performing an arthroplasty on at least one of a glenoid, or humeral head of a humerus through soft tissue of an anatomy, comprising:
forming an entry incision, at a superior-lateral portion of the glenohumeral joint;
forming a passage from the incision through at least the deltoid muscle substantially superior and lateral of the glenohumeral joint;
reaming the humerus from the superior, lateral humeral head without dislocating the humeral head from the glenoid;
resecting the humeral head while the humeral head is located within the glenoid;
inserting a prosthetic stem into an intramedullary canal of the humerus through the incision and the passage;
positioning the prosthetic stem having a central stem axis and a coupling mechanism aligned with the central stem axis within the humerus such that the central stem axis is substantially aligned with a longitudinal axis of the intramedullary canal;
inserting a prosthetic humeral head through the incision and the passage; and
coupling the prosthetic humeral head to the coupling mechanism after the stem is inserted into the humerus;
wherein at least one of the subscapularis muscle or supraspinatous muscle remains intact and completely connected to surrounding bone during the entire arthroplasty procedure.
2. The method of claim 1 , wherein forming a passage through the deltoid muscle allows access to the at least one of a capsule or a rotator cuff surrounding the humeral head.
3. The method of claim 1 , wherein the humeral head comprises a second coupling mechanism configured to be aligned with the central stem axis.
4. The method of claim 3 , wherein coupling the head comprises impacting the head at an angle parallel to the stem central stem axis.
5. The method of claim 1 , comprising disposing an interface member between the head and the stem.
6. The method of claim 5 , wherein the interface member comprises first and second coupling tapers.
7. The method of claim 3 , wherein coupling the head to the stem is coupling the head less than 2 mm from the stem.
8. The method of claim 1 , further comprising resecting the glenoid.
9. The method of claim 8 , further comprising implanting a glenoid implant in the resected glenoid.
10. A method of performing an arthroplasty on a humeral head of a humerus through soft tissue of an anatomy, comprising:
forming an incision in the soft tissue near a glenohumeral joint; prior to resecting the humeral head, reaming the humerus from the superior, lateral humeral head without dislocating the humeral head from the glenoid;
resecting the humeral head while the humeral head is in cooperation with a glenoid of the glenohumeral joint;
positioning within an intramedullary canal of the humerus a prosthetic stem having a central stem axis and a first coupling mechanism having a first coupling axis that is coaxially aligned with the central stem axis, the prosthetic stem is positioned such that the central stem axis is approximately parallel to a longitudinal axis of an intramedullary canal of the humerus; and
coupling a prosthetic head to the prosthetic stem after the stem is positioned within the humerus by mating the first coupling mechanism with a second coupling mechanism of the prosthetic head such that:
the first coupling axis is coaxially aligned with a second coupling axis of the second coupling mechanism; and
a central axis of the articulating surface of the prosthetic head is not parallel to, or coaxial with, either the first coupling axis or the second coupling axis; wherein at least one of the subscapularis muscle or supraspinatous muscle remains intact and completely connected to surrounding bone during the entire arthroplasty procedure.
11. The method of claim 10 , wherein the head defines a stem bearing surface that is substantially perpendicular to the central axis of the articulating surface.
12. The method of claim 10 , wherein coupling the head comprises impacting the head along the second coupling axis.
13. The method of claim 10 , comprising disposing an interface member between the head and the stem.
14. The method of claim 13 , wherein the interface member comprises first and second offset coupling tapers.
15. The method of claim 14 , wherein coupling the head to the stem is coupling the head less than about 2mm from the stem.
16. The method of claim 10 , further comprising resecting a glenoid.
17. The method of claim 16 , further comprising implanting a glenoid prosthetic in the resected glenoid.
18. The method of claim 17 wherein the glenoid prosthetic comprises an articulating surface and an interface surface, said interface surface having a plurality of coupling pegs which engage the surface at a predetermined angle.
19. A method of performing an arthroplasty on a humeral head of a humerus through soft tissue of an anatomy, comprising:
forming an incision in the soft tissue near a glenohumeral joint; prior to resecting the humeral head, reaming the humerus from the superior, lateral humeral head without dislocating the humeral head from the glenoid;
resecting the humeral head while the humeral head is in cooperation with a glenoid of the glenohumeral joint;
positioning a prosthetic stem having a central stem axis and a first coupling mechanism generally aligned with the central stem axis within an intramedullary canal of the humerus such that the central stem axis is approximately parallel to a longitudinal axis of an intramedullary canal of the humerus; and
coupling a humeral head to the first coupling mechanism after the stem is inserted into the humerus;
wherein the humeral head comprises an articulating surface with a head central axis extending through an axial center thereof and a planar coupling surface that lies in a plane that is perpendicular to the head central axis, said planar coupling surface having a second coupling mechanism with a central coupling axis that is non-orthogonal to the coupling surface;
wherein at least one of the subscapularis muscle or supraspinatous muscle remains intact and completely connected to surrounding bone during the entire arthroplasty procedure.
20. The method of claim 19 , wherein the second coupling mechanism is configured to be aligned with the central stem axis.
21. The method of claim 19 , wherein coupling the head to the stem is coupling the head less than about 2 mm from the stem.
22. The method of claim 19 , further comprising resecting a glenoid and implanting a glenoid implant in the resected glenoid.